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Daniel H. Ciccarone, MD, MPH, David E. Kanouse, PhD, Rebecca L. Collins, PhD, Angela Miu, MS, James L. Chen, MPH, Sally C. Morton, PhD and Ron Stall, PhD

At the time of the study, Daniel H. Ciccarone was with the Urban Health Study, Department of Family and Community Medicine, University of California San Francisco and the Center for AIDS Prevention Studies, University of California San Francisco. David E. Kanouse, Rebecca L. Collins, Angela Miu, and Sally C. Morton are with RAND, Santa Monica, Calif. James L. Chen is with the California Epidemiologic Investigation Service, Los Angeles. Ron Stall was with the Division of General Internal Medicine, Center for AIDS Prevention Studies, University of California San Francisco, during the time that this analysis was completed.

Correspondence: Requests for reprints should be sent to Daniel H. Ciccarone, MD, MPH, Urban Health Study, Department of Family and Community Medicine, 3180 18th St, Ste 302, San Francisco, CA 94110 (e-mail: ciccaron{at}fcm.ucsf.edu).

Objectives. We estimated the proportion of HIV-positive adults who have any sexual contact without disclosure and the proportion of their sexual partnerships that involve unprotected sex without disclosure.

Methods. We drew participants from the HIV Cost and Services Utilization Study (n = 1421). Interviews assessed disclosure and sexual activities with up to 5 recent partners.

Results. Overall, 42% of the gay or bisexual men, 19% of the heterosexual men, and 17% of all the women reported any sex without disclosure, predominately within nonexclusive partnerships (P < .001). Across all groups, 13% of serodiscordant partnerships involved unprotected anal or vaginal sex without disclosure, with no significant difference between groups.

Conclusions. Risky sex without disclosure of serostatus is not uncommon among people with HIV.

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